Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events

F.G.R. Fowkes, G.D. Murray, I. Butcher, A.R. Folsom, A.T. Hirsch, D.J. Couper, G. DeBacker, M. Kornitzer, A.B. Newman, K.C. Sutton-Tyrrell, M. Cushman, A.J. Lee, J.F. Price, R.B. D'Agostino Sr, J.M. Murabito, P.E. Norman, K.H. Masaki, L.M. Bouter, R.J. Heine, C.D.A. StehouwerM.M. McDermott, H.E.J.H. Stoffers, J.A. Knottnerus, M. Ogren, B. Hedblad, W. Koenig, C. Meisinger, J.A. Cauley, O.H. Franco, M.G.M. Hunink, A. Hofman, J.C. Witteman, M.H. Criqui, R.D. Langer, W.R. Hiatt, R.F. Hamman, the Ankle Brachial Index Collaboration

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS.An analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events.Subjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS?+?ABI, were fitted for the primary outcome of major coronary events.In predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS?+?ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p?=?0.050) and 9.6% (95% CI 6.1 to 16.4%, p?
Original languageEnglish
Pages (from-to)310-320
Number of pages11
JournalEuropean Journal of Preventive Cardiology
Volume21
Issue number3
DOIs
Publication statusPublished - Mar 2014

Keywords

  • PERIPHERAL ARTERIAL-DISEASE
  • CORONARY-HEART-DISEASE
  • LOWER-EXTREMITY
  • FOLLOW-UP
  • TASK-FORCE
  • PRACTICE GUIDELINES
  • PRESSURE INDEX
  • OLDER-ADULTS
  • PRIMARY-CARE
  • ALL-CAUSE

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